Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Ailesel Akdeniz Ateşi Tanılı Hastalarda Atak ve Atak Dışı Dönemlerdeki Nötrofil Lenfosit Oranı ve Ortalama Trombosit Hacminin Değerlendirilmesi
Evaluation of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume in Attack and Attack-Free Periods in Familial Mediterranean Fever Patients
Cem ÖZİŞLERa
aRomatoloji Kliniği, Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2019;39(2):179-86
doi: 10.5336/medsci.2018-62619
Article Language: TR
Full Text
ÖZET
 Amaç: Ailesel Akdeniz ateşi (AAA) tanılı hastaların atak ve atak dışı dönemlerindeki nötrofillenfosit oranı (NLO) ve ortalama trombosit hacmi (OTH) değerlerinin tespit edilmesi ve bu değerlerin akut faz belirteçleri ve MEFV gen mutasyonları ile olan ilişkisinin araştırılmasıdır. Gereç ve Yöntemler: Çalışmaya 97 AAA tanılı hasta ve 60 sağlıklı kontrol olgusu dahil edildi. Demografik özellikler ve laboratuvar verileri retrospektif olarak kaydedildi. Bulgular: NLO değeri atak dönemindeki AAA hastalarında ataksız dönem hasta ve kontrol gruplarına göre anlamlı bir şekilde daha yüksek saptanmıştır (sırasıyla 4,67±3,66 vs 1,83±0,64, 4,67±3,66 vs 2,03±0,66). OTH düzeyleri atak döneminde ataksız döneme göre anlamlı olarak daha düşük saptanırken, atak dönemi ile kontrol grubu arasında bir fark tespit edilmedi (sırasıyla 8,53±1,12 vs 8,89±1,28, 8,53±1,12 vs 8,74±0,89). Atak döneminde NLO ile C-reaktif protein (CRP) arasında anlamlı bir korelasyon bulundu. Ataksız dönemdeki NLO değeri, M694V homozigot mutasyonu taşıyan olgularda taşımayanlara göre anlamlı olarak daha yüksek tespit edildi (2,16±0,79 vs 1,76±0,57). Sonuç: AAA tanılı hastaların atak dönemlerinde NLO düzeylerindeki yükselme ve OTH değerlerindeki düşme birer akut faz belirteci olarak kullanılabilir. Ataksız dönemlerdeki NLO düzeylerinde yükselme, özellikle M694V homozigot mutasyonu taşıyan olgularda, bir subklinik inflamasyon belirteci olarak değerlendirilebilir ve amiloidoz gelişimi açısından daha farkında olmamızı sağlar.

Anahtar Kelimeler: Ailesel Akdeniz ateşi; inflamasyon
ABSTRACT
 Objective: To determine the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) values in the attack and attack-free periods of familial Mediterranean fever (FMF) patients and to investigate their association with acute phase reactants and MEFV gene mutations. Material and Methods: 97 patients with FMF and 60 healthy controls were included in this study. Demographic characteristics and laboratory data were retrospectively recorded. Results: NLR values were significantly higher in the FMF patients at the time of attack than in the attack-free patients and control groups (4.67±3.66 vs 1.83±0.64, 4.67±3.66 vs 2.03±0.66, respectively). MPV levels were significantly lower in the attack period compared with attack-free period and there was no difference between the attack period and the control group (8.53±1.12 vs 8.89±1.28, 8.53±1.12 vs 8.74±0.89, respectively). There was a significant correlation between NLR and C-reactive protein (CRP) during the attack period. The NLR value in the attack-free period was significantly higher in the cases with M694V homozygote mutation than in the cases without this mutation (2.16±0.79 vs 1.76±0.57). Conclusion: Increase in NLR levels and decrease in MPV values can be used as acute phase reactants in the attack periods of patients with FMF. Elevation of NLR levels in attack-free period can be considered as a subclinical inflammatory marker especially in cases with M694V homozygous mutation and allows us to be more alert to the development of amyloidosis.

Keywords: Familial Mediterranean fever; inflammation
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